This mentored patient-oriented research career development award is designed to refine clinical training and research expertise in the area of personal factors among men and women with bipolar disorder (BPD) that are involved in treatment adherence. The research aim of this proposal includes a study to examine how symptoms, gender, psychosocial supports, and locus of control contribute to illness behavior in BPD, as well as assessing the interaction between illness behavior in BPD and adherence to treatment in men and women with BPD. The research projects emphasize novel applications of health services technology to the area of treatment of BPD, and are designed to complement each other in that they include subjects treated in both community and academic settings, assess the wide spectrum of BPD manifestation (including rapid cycling illness), and obtain data utilizing both quantitative and qualitative techniques. Project one is a prospective study utilizing a multidimensional measurement design to examine the relationships between symptoms, gender, psychosocial supports, locus of control, illness behavior in BPD, and treatment adherence in men and women with BPD being treated with mood stabilizing medications. The project will identify factors that promote adherence in patients with BPD, and evaluate the role of specific indices of illness behavior in BPD as it affects treatment adherence. A second project focuses on identification and assessment of key features of illness behavior and treatment adherence among men and women with rapid cycling bipolar disorder, a high-risk sub-population of individuals with 9ipolar illness. Project two is an exploratory, cross-sectional study, which will emphasize the use of a qualitative, anthropological instrument to systematically explore nuances of illness behavior in BPD as they relate to adherence. The proposal also includes a strong training component. Close supervision is provided by Co-mentors from Case Western Reserve University, Janis Jenkins, Ph.D., Professor of Anthropology, and Joseph Calabrese, MD, Professor of Psychiatry. The proposal includes frequent consultation with national experts in bipolar disorder, applied health services research, research ethics and treatment adherence, as well as formal coursework in statistics and research design. The candidate is thus assured a sound base of knowledge and practical research experience with clinical, qualitative and quantitative methods required for her research career in studying critical personal factors among individuals with bipolar disorder which affect both treatment adherence, and ultimately, treatment outcome.